Dr. Colm Henry:

A traditional outpatient clinic of course means senior decision-makers but I do not accept this as a model for the way patients need to be seen. We are broadening it out. For example, there are 14 rapid ambulatory gynaecology clinics where advanced nurse practitioners who are trained in that specialty see and complete loops of treatment. I saw one in Letterkenny recently where 750 patients were seen in one year by two nurses. There were only 21 returns. They completed a loop of treatment within a common governance. The Deputy's point about outpatient clinics is correct. There needs to be senior decision-makers but I would go further than that and say we cannot endlessly rely on a model of care that is unsustainable.